Smartcare Infertility - ART

(Assisted Reproductive Technology)

in

Global Leader in Assisted Reproductive Technology(ART)

In Korea, the first IVF(In Vitro Fertilization) baby was reported in 1985 by Prof. Chang Yoon Seok at Seoul National University Hospital, then, Korea was recorded as the 10th country succeeded in live birth from IVF in the world.

Advanced treatments of ART in Korea

In Vitro Maturation using immature oocyte-In Vitro

Trace of developmental history of ART in Korea

First IVF baby in Korea

(TV-OPU, Transvaginal USG-guided Ovum Pick-Up)

First baby from frozen embryo

Selective fetal reduction Surrogacy pregnancy

First babyfrom immature oocyte in the world

Why Korea?

Oocyte cryopreservation using Slush Nitrogen

First live birth using

~ frozen oocyte In Cancer Survivor

PGD(Preimplantation Genetic Diagnosis)Pregnancy from spinal muscular atropy

Embryonic stem cell line was established

TESE(TEsticular Sperm Extraction) -NOA(Non-Obstructive Azzoospermia) Pregnancy

Fertilization(IVM-IVF)

IVM refers to aspiration and in vitro maturation of immature oocytes from small antral follicles at the stage prior to selection and dominance. In this infertility treatment, immature oocytes are retrieved from the unstimulated or minimally stimulated ovaries and matured in a maturation medium supplemented with follicular fluid and gonadotropins. Patients can benefit from IVM procedure reducing the risk of OHSS(ovarian hyperstimulation syndrome), avoiding potential side effects of COH(Controlled Ovarian Hyperstimulation) using gonadotropic releasing hormone and gonadotropins and reducing the cost for COH.

Cryopreservation & Fertility Preservation

Korea has been the pioneer in the field of reproductive medicine using cryopreservation techniques such as vitrification for over 20 years introducing cutting-edge technology year after year and bringing hope and new life into the homes of countless families.

Embryo cryopreservation 1) For infertility patients 2) For cancer patients

1. With the introduction of the latest technology and creative research, IVF technology is excellent and pregnancy rate is high. 2. The success rate of pregnancy is high through intensive treatment especially in patients with repeated IVF failure and the advanced maternal

age. 3. Highly qualified medical services: delicate care, transparent IVF cost 4. Provide donation and surrogate programs 5. Closely connection with medical staffs before and after the procedure 6. Environment is convenient and pleasant - sightseeing the city sightseeing

Embryo freezing before cancer treatments for a married woman diagnosed with cancer

Social Oocyte Banking (freezing) for single women Oocyte Cryopreservation and Thawing Process(using Slush Nitrogen Vitrification)

Oocyte Retrieved Long-term storage Pick-up Oocyte in Nitrogen Tank

after Vitrification

Embryo Intracytoplasmic Thawed Transfer Sperm Injection Oocyte

(ICSI)

Advanced treatments of ART in Korea

Blastocyst Transfer

There are two possibilities for embryo transfer in IVF: either a ① cleavage-state embryo or ② a blastocyst embryo can be transferred.

✽ Advantages of Blastocyst Transfer

1. Synchronization

2. Embryo Selection

3. for PGD(Preimplantation Genetic Diagnosis) /

PGS(Preimplantation Genetic Screening)

4. Higher implantation rates

Preimplantation Genetic Diagnosis/ Preimplantation Genetic Screening What is PGD?

Pre-implantation genetic diagnosis (PGD) refers to the genetic test on cells removed from embryos (embryos prior to implantation, and sometimes even of oocytes prior to fertilization), to help select the best embryo(s) for pregnancy or to be free of a genetic disease. PGD thus is an adjunct to assisted reproductive technology, and requires in vitro fertilization (IVF) to obtain oocytes or embryos for evaluation. PGD is an option not to transmission of genetic diseases or recurrent miscarriages in a similar fashion to prenatal diagnosis.

Preimplantation genetic screening (PGS); Aneuploidy Screening

Aneuploidy screening reduces the chance that a transferred embryo has a chromosome abnormality. The most common chromosome abnormalities in miscarriages include: trisomy (three copies of a chromosome) or monosomy (one copy of a chromosome) for chromosomes 13, 15, 16, 18, 21, or 22; triploidy (three copies of all the chromosomes); and abnormalities of the sex chromosomes.

Advanced treatments of ART in Korea

Time lapse embryo monitoring system

Time-lapse Embryo Incubator

The principle of this device is that the embryo is not exposed to the outside of the incubator until the day of embryo transfer, but the image of all embryos is visualized and then the best embryo is selected using a special program.

✽ Proven clinical benefits of Time-lapse Embryo Incubator

Reduced pregnancy loss

Improved implantation rate

Shorter time to pregnancy

Treatment of Male Infertility

Microsurgical TESE(TEsticular Sperm

Extraction) is an effective sperm retrieval from men with NOA(Non- Obstructive Azzoospermia) for ICSI. The procedure is performed through a very small incision in the midline of the scrotum. Surgeon open the testicles through this incision

and look under a high power, operating microscope (at 20-25X magnification) for seminiferous tubules that are swollen and contain sperm. The advantages of this technique are mindlscjsimally invasive technique, removal of minimal amount of testicular tissue and minimalizing negative impact on testicular function. Figure. Microsurgical TESE. arrow

exposured pink thickened seminiferous tubules, isolated regions of spermatogenesis

within the testis (Kim et al., Korean J Urol. 2008)